Criticism directed by caregivers towards a family member with schizophrenia, both from the perspective of the patient and of the caregiver, predicts relapse, although both perspectives differ. This study aims to verify if the same applies to a Mediterranean sample, where criticism is not the main attitude of high expressed emotion families. The Camberwell Family Interview was applied to assess the family's perspective, and the Perceived Criticism and the Family Emotional Involvement and Criticism Scales were used to assess the patients' perspective, in 21 dyads. The association between both perspectives and psychotic symptoms was also examined. Results replicated those of previous studies in other countries, revealing that the perspectives on Criticism of patients and families do not match. The fact that family members also presented positive attitudes towards the patient did not cushion the patient's perceived criticism. Thus, it seems that families considered to be critical may not be perceived as such by the patients. Furthermore, only the warmth from the family's perspective correlated with the symptoms: positive affect proved to be more relevant than negative affect. Therefore, the patients' subjective assessments and family warmth should be included in clinical and research proposals.
En el presente trabajo teórico se revisan cuestiones de diferente índole relacionadas con la Emoción Expresada (EE), un campo de trabajo que desde sus inicios a finales de los años sesenta ha llegado a ser muy fructífero para el entendimiento de los factores familiares implicados en los trastornos mentales graves y enfermedades de curso crónico, aunque al que no se le ha dedicado demasiada reflexión crítica. En varios aspectos se hace necesaria una actualización desde una mirada comprehensiva de la literatura que permita avanzar cualitativamente en su estudio, y que repercute en sus aplicaciones clínicas. Primero, se aboga por la consideración de la baja EE y la inclusión de los aspectos positivos, fundamentalmente la calidez, como factores de protección, redirigiendo el tema hacia la psicología positiva. Segundo, se subraya la naturaleza bidireccional y diádica de las relaciones entre pacientes y sus familias en torno a la EE, con las consecuentes implicaciones metodológicas y prácticas a nivel de medida, diseño de estudios y trabajo clínico.
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